reunion anual madeira 2015 estudios en cardiología intervencionista desde el último congreso que...
Post on 04-Aug-2015
45 Views
Preview:
TRANSCRIPT
Estudios en cardiologia intervencionista desde el ultimo congresoque han tenido un impacto en nuestra practica diaria
Cardiopatia EstructuralEduardo Infante de Oliveira
H. Santa Maria, Lisboa, Portugal
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI superiority vs. SAVR
US Corevalve Implication:
TAVI should be the preferred treatment for
patients with symptomatic severe AS at
increased risk for surgery
And what about intermediate risk patients?
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI in intermediate risk patients
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI in intermediate risk patients
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI in intermediate risk patients
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVITAVI in intermediate risk patients
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVITAVI in intermediate risk patients
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVITAVI in intermediate risk patients
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVITAVI in intermediate risk patients
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVITAVI in lower risk patients
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI in lower risk patients
NOTION trial:
First trial to randomize lower risk patients
TAVI was safe and effective
TAVI was comparable to SAVR (death, stroke, MI)
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
TAVI - summary
Preferable to surgery in high risk patients (2-years FU)
Low mortality / complications rate in intermediate and low risk patients
Seems to be as safe and effective as SAVR in lower risk patients
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
LAAOne-sided 95% upper CI bound for
success
2.0% 2.5% 3.0%Percent of patients experiencing an event
2.2%2.618%
2.67%
Early Safety
95% upper CI bound for non-inferiority
0.5 1.0 1.518-month Rate Ratio
2.0
1.07
0.57 1.89
1.75
Primary Efficacy95% upper CI bound for non-inferiority
-0.01 0 0.01
18-month Rate Difference
0.02
0.0053
-0.02 0.03-0.03
-0.0190 0.0273
0.0275
Late Ischemic Efficacy
Holmes, DR et al. JACC VOL. 64, NO. 1, 2014
PREVAIL trial
Left Atrial Appendage Occlusion
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
Left Atrial Appendage Occlusion
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
LAAO – ESC guidelines 2012 – Can we aspect changes?
Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal
LAAO – ESC guidelines 2012 – Can we aspect changes?
IIa A
Estudios en cardiologia intervencionista desde el ultimo congresoque han tenido un impacto en nuestra practica diaria
Cardiopatia EstructuralEduardo Infante de Oliveira
H. Santa Maria, Lisboa, Portugal
top related